Normal Pressure Hydrocephalus (NPH) Treatment in India
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What is Normal Pressure Hydrocephalus?
A disease known as normal pressure hydrocephalus (NPH) is brought on by an accumulation of cerebrospinal fluid inside the skull that presses against the brain. People over 65 are most prone to have this disorder. It is frequently curable and occasionally even reversible. A shunt is surgically implanted to drain extra fluid from the inside of your head in order to treat this illness.
What can I expect if my parents have Normal Pressure Hydrocephalus?
They have the following issues
- Gait issues
- Urinary incontinence
- Cognitive difficulties
- They could struggle to raise their feet, take shorter, unsteady strides, freeze or move erratically, and turn their toes outward while walking
- Urinary incontinence occurs when you lose control of they bladder and inadvertently urinate. In the early stages, this may result in frequent urination, an exceptionally intense, difficult-to-control urge to urinate, or both
- Cognitive difficulties are the third major category of NPH symptoms. This symptom may manifest as or result from any of the following
- Slowness, both mentally and physically. This occurs when someone exhibits symptoms of thinking or moving more slowly than normal
- Memory issues. People who have this tend to seem forgetful or unfocused
- Dysfunction of the executive. People find it difficult to control their thoughts, feelings, and behaviours as a result. This may also manifest as difficulties concentrating and focusing, or as delayed and erratic decision-making
- A shift in emotions. Individuals with NPH may exhibit signs of apathy or disinterest in activities they once found enjoyable.
What are the Common Symptoms of Normal Pressure Hydrocephalus?
- Walking difficulties (feeling as though the feet are stuck to the ground)
- Unstable balance
- Dropping
- Modifications to your gait
- Confusion and forgetfulness
- Changes in mood
- Depression
- Having trouble answering inquiries
- Absence of bladder control
Causes, Risk Factors and Complications of Normal Pressure Hydrocephalus?
Causes
NPH happens when there is a blockage in the normal flow of cerebrospinal fluid (CSF) across the brain and spinal cord. The cause is frequently unknown, however it could be a brain tumor, bleeding, infection, prior trauma, or brain surgery. The ventricles swell and press against surrounding brain tissue when there is an accumulation of extra CSF fluid. Damage to the brain may result from this excess fluid and pressure.
Risk Factors
Individual is more likely to develop NPH if he
- Is over 60 years old.
- Has an infection in their brain.
- Suffered a head injury.
- Possess a brain tumor.
- Have had brain surgery
Complications
The complications of NPH include:
- Trouble walking
- Trouble thinking
- Loss of bladder control
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Latest Research and Technologies in the Treatment of Normal Pressure Hydrocephalus in India.
Since the 1950s, pharmacological treatments have been investigated both in clinical and experimental settings to prevent hydrocephalus and eliminate the need for shunting. Although there is still some promise in the latter areas, clinical trials of varying quality have not shown long-lasting and convincing protective effects through manipulation of blood clot fibrinolysis, diuresis, cerebrospinal fluid production, or subarachnoid compartment fibrosis.
Normal Pressure Hydrocephalus Prevention Tips
NPH is unpredictable, and half of its cases are idiopathic - that is, they occur for unidentified causes. There is no way to avoid idiopathic NPH, and there is no way to lower your chance of developing it.
However, by avoiding situations or events that can lead to secondary NPH, you can lower your risk of developing this illness. Among the actions you can do are:
Don't disregard infections. This is particularly crucial for infections of the eyes and ears since they can quickly travel to the brain and result in meningitis or encephalitis. Put on protective gear. Secondary NPH may result from traumatic brain injury. You can prevent head injuries that could result in this syndrome by wearing a helmet and other protective gear.
Control your medical issues. NPH can result from conditions like high blood pressure that cause issues like brain hemorrhage or aneurysms. The risk of these issues can be decreased by controlling your blood pressure and taking care of associated diseases like Type 2 diabetes or high cholesterol.
Treatment options for Normal Pressure Hydrocephalus (NPH)
VP Shunt : Surgery to insert a tube, known as a shunt, into the brain to drain the extra fluid is a typical treatment for NPH. Typically, the shunt is placed into a brain ventricle before being transferred beneath the skin from the head to the neck, chest, and abdomen. Your body absorbs the extra fluid in your brain once it passes through the shunt and into your abdomen. After that, your brain's ventricles can return to their typical size. As long as the brain contains an excessive amount of CSF, the shunt remains in place.
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Endoscopic Third Ventriculostomy: A minimally invasive endoscopic treatment can be used to treat patients with obstructive hydrocephalus by avoiding the blockage and reestablishing normal cerebrospinal fluid (CSF) flow.This surgery offers a lower risk of overdrainage issues and helps prevent the placement of a ventriculoperitoneal shunt. For patients, endoscopic third ventriculostomy (ETV) provides a long-lasting surgical option. In a small percentage of patients, this internal bypass may close or prove inefficient, necessitating a shunt. Despite the possibility of bleeding and infection, this surgery is often well tolerated.
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A combination of the following techniques can be used by a medical professional to diagnose NPH.
Neurological and physical examination. During these examinations, a medical professional searches for outward manifestations of a disease. They also assess your reflexes, arm and leg muscle strength, and senses (hearing, touch, vision, etc.).
inquiring about your symptoms and medical background. Your symptoms, medical history, and records can all offer crucial hints that a healthcare professional might use to diagnose NPH.
Imaging for diagnosis. The most crucial diagnostic method for NPH is magnetic resonance imaging (MRI) scanning. With this imaging examination, a healthcare professional can "look" inside your head to see areas of fluid accumulation and your brain. Although it is less usual, your physician can alternatively suggest a cisternogram scan. While CT scans can be useful in ruling out other illnesses, they are typically not useful in diagnosing NPH.
laboratory examinations. A spinal tap, often known as a lumbar puncture, enables a medical professional to obtain a CSF sample for laboratory analysis. While it can help rule out other illnesses, this cannot diagnose NPH. If NPH develops as a result of another illness, such as meningitis, it can also aid in the diagnosis.
- Physical therapists and physicians who specialize in rehabilitation medicine, known as physiatrists, consult with patients who have a shunt installed in the days prior to and following surgery to assess the degree of care required during the healing process.
- After surgery, many people find that physical therapy helps them walk more easily and balance better
- Following surgery, walking and balance are usually the first symptoms to get better. If necessary, rehabilitation can teach patients how to use a cane or walker so they can become as independent as possible
- After shunt surgery, many patients report improved walking within a few weeks when working with a physical therapist
- Following shunt surgery, memory and cognitive abilities frequently take a while to recover, and some patients may experience cognitive deficiencies. Cognitive therapy is used in rehabilitation to address the cognitive difficulties linked to normal pressure hydrocephalus. Neuropsychologists and cognitive therapists can help people think and remember better.
- To treat the condition's impact on speaking, rehabilitation may also involve speech or language pathologists. The patient and the therapist can work on a range of communication issues that might result from normal pressure hydrocephalus, including articulation issues and issues with the strength, coordination, and agility of the jaw, lips, and tongue
- Working with an occupational therapist can also help people with safety, balance, coordination, and better functioning at home following surgery.
Because shunts are used to treat normal pressure hydrocephalus. No drugs are administered. Only, after surgery, rehab medication may be needed.
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Hospitals for Normal Pressure Hydrocephalus (NPH) in India
VPS Rockland Hospital
Gurgaon, India
VPS Rockland Hospital located in Gurugram, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Well-designed compact 103-bed hospital expanding over120,000 square feet
- Well equipped modular operation theatres, intensive care unit, interventional Cath lab, and in-patient rooms ranging from economy to luxury
- Offers a bouquet of services like Internal Medicine, Obstetrics & Gynaecology, Surgery, Pediatrics
- High-end diagnostic services like 1.5 T MRI and 128 slice CT Scan
- Advanced non-invasive assessment with echo & TMT machines
- State of the art cardiac Cath-Lab
- Appointment Scheduling
- Treatment packages
- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
- Laundry services
- Prayer room
- Visa assistance
- Pick and drop facility from/to the Airport
- Foreign exchange facility
- Registration with the Foreigners Regional Registration Office
- Dedicated Neuro-Intensive care unit managed by expert intensivists
- Accommodation arrangements post discharge
- Highly advanced instruments for deep brain stimulation, stereotaxy, micro-neurosurgery, pediatric neurosurgery & neurophysiology
- Most advanced dialysis machines and advanced diagnostic and therapeutic facilities
- Renal replacement therapy for hemo-dynamically unstable patient
- Technologically advanced endoscopy suite
- Wi-Fi/internet service in the room
- Travel arrangement for patient & attendant post discharge
- Tele-consults post discharge
- Dialysis beds
- 24x7 ‘Trauma & Emergency Center
- Dedicated blood bank
- 24x7 comprehensive patient care.
- Deployed high-end technologies & smart digital system
- Robust Hospital Information Systems to meet complex medical needs of patients
- Robotic-assisted surgeries
- International Patients Lounge
The Madras Institute of Orthopedics and Traumatology
Chennai, India
MIOT started its journey with only 70 beds and focusing on Orthopedics and Trauma care. However, we grew into a multi-specialty hospital with time. MIOT is now a 1000-bedded hospital and can offer an extensive range of services across 63 specialties. The state of art laboratory of our hospital is ranked 8th internationally. We have 21 super-specialty operation theaters equipped with cutting-edge technology to help our doctors with complex procedures.
We take great care to make our patient rooms comfortable enough. The patient rooms get plenty of fresh air as well as natural light. The soothing views from the rooms do not let the patients feel cut off from the outside world. We use separate entrances for emergency patients, out-patients, in-patients, and their attendants. We put our patients’ safety first which is why we use a superior air system to ensure a near-zero infection healthy environment.
Apart from that, MIOT’s 24 hours blood bank provides all kinds of blood work related services which include blood collection to component separation. This state-of-art blood bank alone handles more than 30,000 units of blood over the course of a year. Every month around 600 blood transfusions are managed by this blood bank.
MIOT’s SIGNA Pioneer 3T MRI machine is made with noise reduction technology. This silent MRI machine can deliver superior quality neuroimages without wasting any time. The department of Radiology and Imaging Sciences can give tough competition to any international hospital with its advanced technology and accuracy.
The PET CT service at MIOT International is the first of its kind in South India enabling better and more accurate diagnosis than earlier. The superior diagnosis is also possible for the two digital cath labs at MIOT Heart Revive center.
We also have a physiotherapy team where a team of highly efficient physiotherapists deals with the mobility and functional disability issues of our patients. They listen to the patients carefully to identify the root of the pain and use therapeutic exercises to reduce their pain.
The CCU of MIOT is something to be proud of. The specially-trained staff of this unit is dedicated to ensuring top-quality medical support to serious patients. This unit along with the MIOT International Laboratory is the backbone of our facility.
Furthermore, what makes MIOT unique is our Telemedicine service. In the new normal, we are trying everything to reach our patients. Our one of its kind Telemedicine service connects our patients to our 250 full-time doctors over email, phone, chat and video consultations.
Sanar International Hospital
Gurugram, India
Sanar International Hospital is a multispeciality hospital based on Golf Course Road in Gurugram, a part of Delhi NCR. It was founded in 2018 and houses one of the most comprehensive and advanced surgical care specialties. This 150-bedded facility is committed to providing the best patient experiences and healthcare services is the core of the hospital’s mission. Staffed by a group of visionary and competent medical professionals who are well-versed in their fields and eminent for their empathy and understanding, Sanar International Hospital provides optimal care to its patients, making it a popular
Specialties in the Hospital such as Heart, Bone, and Joint neurosciences, Cancer, Kidney and Liver Transplant, and other successful procedures along with experienced medical professionals have made a mark for themselves among domestic patients and international patients who come to India to have the finest healthcare services. It follows strict international practices and believes that the centricity of the patient is essential for providing high-quality care through world-class infrastructure and state-of-the-art facilities. The technologies offered by the Hospital include Digital X-rays, MRI, CT, Ultrasound, transfusion medicine, pharmacy, laboratory services, 24 hrs emergency and ambulance services.
It offers more than 20 plus specialties such as General Medicine, Anesthesiology, Cardiac Sciences, Ophthalmology, Gastroenterology, Hematology, Orthopedics, General Surgery & Surgical, Cardiothoracic Surgery, Hepato Biliary Surgery, Pediatrics, Liver Transplantation, and Critical Care Medicine. The Hospital has a highly skilled medical staff of neuro-anesthetists, neurologists, specialized neurocritical care experts, neurosurgeons neuropsychologists, and neuropsychiatrists. There are specific centers for the treatment of epilepsy, stroke, brain tumors, movement disorders, spinal problems, and headaches.
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Why Choose India for Normal Pressure Hydrocephalus Treatment?
Here are some of the reasons for choosing India:
- Due to advancements in medical facilities, such as minimally invasive surgical techniques.
- World-class experts include highly experienced doctors, JCI, and NABH-accredited healthcare institutions.
- Compared to other countries, treatment in Indian hospitals is cost-effective.
- Indian hospitals provide international patient services, including a multilingual support system.
- Improved treatment methods and biological therapies.
Frequently Asked Questions
Yes, normal pressure hydrocephalus can be treated using shunt procedures. However, some patients may require a long time for recovery and may require rehabilitation.
With skilled neurosurgeons and cutting-edge medical technology, India has demonstrated significant success rates in treating normal pressure hydrocephalus. The nation's healthcare institutions offer top-notch treatment alternatives, guaranteeing successful outcomes for many patients.
Yes, many Indian hospitals offer the following for neurofibromatosis treatment:
- Advanced diagnostic tools like MRI, CT scan, electromyography, and PET scan for accurate neurofibroma diagnosis.
- Skilled neurologist and surgeons for normal pressure hydrocephalus.
- Advanced VP Shunt and Endoscopic third ventriculostomy procedures.
- Comprehensive post-surgery care and rehabilitation for long-term health benefit.
Always consider the following factors when selecting Indian hospitals:
- Hospitals that are accredited (authorised by JCI and NABH).
- Patient reviews and success rates.
- Hospitals that provide seamless care to patients from abroad.
In general, normal pressure hydrocephalus treatment has much improved in India. The success rate largely depends on how early diagnosis is made. Some patient may completely recover after surgery while others require rehabilitation with various therapies for recovery.
You need to check them to determine if they have any problems walking, if they have trouble holding their urine, and if they have just started to have walking and memory problems.
Untreated symptoms can develop over time and have a substantial negative influence on a patient's quality of life, including increasing difficulties walking, cognitive issues, difficulty with complicated tasks, urine incontinence, and mood swings;
The most likely course of treatment for your parents with NPH is surgery to install a shunt to prevent fluid accumulation inside your brain. In order to assist prevent any problems, you will usually need to do the following if they have a shunt:
- After surgery, adhere to your doctor's instructions. After surgery, you should pay particular attention to areas of skin that have been stitched or stapled. By properly caring for these regions, you can prevent infections and other problems
- Steer clear of magnets if you can. This is not a need for all shunts because not all shunts use magnetically adjustable valves. If this is the situation for your parents, you can find out from your healthcare professional
- Exercise caution when moving and doing things. Make sure your parents refrain from any physical activity that can cause the shunt, inflow and outflow catheters, etc. to come loose or harm them
- Consult your provider as advised. To help prevent problems from this illness, follow-up visits are crucial. Through these appointments, your provider can keep an eye on your parents' health and, if needed, modify their shunt
- Be mindful of the symptoms. Inform your healthcare physician right away if you observe your parents exhibiting a recurrence of an NPH symptom. Recurring symptoms may be a sign of a shunt issue. The longer the symptoms continue and grow, the more likely that they will have complications.
Reviewer
Dr Sonal Gupta
Neurosurgeon
29 Years of Experience
Dr. Sonal Gupta has an experienced neurosurgeon with more than 29+ years of clinical expertise. She is currently the Director, Neuro & Spine Surgery at Fortis Hospital, Shalimar Bagh. Before joining Fortis, she has been associated with various organizations such as Maharaja Agrasen Hospital, Action Balaji Hospital, and Max Hospital. View More
Last Reviewed - January 2026